Water is vital for humans, big and small. However, you can get too much, especially in infancy. Giving babies water too early can have dire outcomes.
It can interfere with your little one’s feedings, and a system imbalance or a condition called water intoxication can occur.
First-time parents often wonder when babies can have water, particularly during warm summers. They may often hear advice or receive pressure from grandparents and other extended relatives to give their baby water. Don’t worry — we’ll walk you through everything you need to know to keep your baby healthy, hydrated, and happy.
When Can Babies Have Water?
You have to be careful when you start giving water to your little one. It’s recommended to wait until after you start your baby on solids, which is around the six-month mark (1). Although solid foods may be offered as young as 4 months old, you should still avoid water until after your infant is 6 months old.
Up until this point, your baby doesn’t need water. They get both the nutrition and hydration they require from breast milk or formula.
How to Introduce Water
Some babies enjoy their first taste of water, and you’ll have to limit them. Others may spit it out quickly, so introducing it is a little harder.
To begin with, most parents use either a cup or bottle — a teaspoon also works. Whatever you and your baby are most comfortable with is fine. Bottles are great to try first, though, since they’re used to the sucking motion.
Once your little one is accustomed to taking water, you can begin to encourage them to hold the container by themselves. Place it in their hands, but keep holding it at the end until they’re fully confident.
No-spill sippy cups are a godsend when you’re encouraging independent drinking. Your baby can take sips on their own, without spilling.
Water should be an additional fluid that is offered, not a replacement for breast milk or formula. In other words, sips of water should be given between meals and regular feedings. I encourage this more during the warmer weather months when maintaining hydration can be more challenging.
Editor's Note:Dr. Leah Alexander, MD, FAAP
How Much Should My Baby Have?
For 6- to 9-month-old babies, you should only offer water in moderation. They only need a few sips to help with hydration and to get them used to the taste.
From 9 to 12 months, you can give about 2 to 4 ounces per day. Offer them their solid meal to help with hydration and digestion.
Continue giving them breast milk or formula. Keep their diet varied with nutritious foods to ensure they stay healthy.
As your baby grows, you can increase their water intake. After their first birthday, you don’t have to be as careful.
From that point on, your toddler should drink about 32 ounces per day, around four cups (2). Try to keep the water intake strictly between meals, and then during mealtime, offer them whole milk instead.
You can give your baby juice after six months, but it often contains a lot of sugar and doesn’t offer any nutritional value. It’s okay as a once-in-a-while refreshment, but it shouldn’t substitute for formula or breast milk. In clinical practice, I discourage giving juice, stating that it can be a treat but it is not a dietary requirement. More nutrition is obtained from eating the fruit itself. Some of my parents say that they “dilute juice with water” in a variety of water to juice ratios. This still gives more sugar than is necessary, and can be detrimental to newly erupted teeth.
Editor's Note:Dr. Leah Alexander, MD, FAAP
Reasons You Shouldn’t Give Infants Water
1. It Fills Their Tummies
Giving water to babies who are under 6 months of age can cause issues. One of the big issues is that the water fills up their tummy, making them feel full without actually eating. If this continues, your little one will inevitably lose weight, which can result in other complications such as malnutrition.
2. It Interferes with Absorption of Nutrients
In addition to making your baby feel full, giving water too early can disrupt their system. The water interferes with how their body absorbs the nutrients they get from formula and breast milk (3).
3. Water Intoxication
Water intoxication is a severe but rare occurrence. It happens because a baby’s kidneys are not mature enough to filter water. By giving your infant too much, their bodies begin to dilute essential sodium and expel it with the leftover water (4)
Sodium is essential for brain activity, so losing excessive amounts can affect moods and consciousness.
Extreme dilution of sodium in the body causes tissues to swell, interfering with your baby’s system.
Symptoms of water intoxication include low body temperature, puffiness in the face, irritability, fussiness, or drowsiness (5). Severe water intoxication can result in seizures, coma, and even death (6).
Before you panic, know that it takes a significant amount of water to cause water intoxication. It can result from excessive water in as little as 90 minutes as seen in a case study from Pediatrics (7).
Be mindful of the possibility of excessive water intake during bath or pool time. Babies love exploring, and to them, that means tasting. Being surrounded by liquids, it’s almost irresistible for them to try to swallow some.
Limit the amount your baby swallows by keeping a close eye on them when spending time in the water.
Diluting Formula with Water
Diluting formula to prevent dehydration or to make that formula last longer it isn’t recommended (8). Formula is a carefully constructed recipe, containing the correct amount of nutrients your baby needs to grow.
Every packet has directions for use, indicating how much water to use. Adding more water will put your baby at risk of water intoxication.
When diluting the powder, you’re also weakening the ingredients. If you add extra water, your little one will receive fewer nutrients than they need.
Always follow the directions for preparing formula precisely. If you have any issues, contact your child’s pediatrician.
Babies who are feeding and gaining weight well are unlikely to become dehydrated under normal circumstances. The time they are susceptible to dehydration is when they’re experiencing illnesses such as colds, vomiting, and diarrhea (9).
Babies tend to refuse to feed or eat less during sickness. If they’re experiencing symptoms like vomiting and diarrhea, or perhaps the two simultaneously, they’re losing more fluid than they’re taking in. This is a recipe for dehydration, and extra care should be taken.
Still, avoid giving your baby an excessive amount of water. Offer small sips throughout the day along with the bottle or breast milk. Watch for symptoms of dehydration such as fewer wet diapers, no tears when crying, or unusual tiredness (10).
Contact your pediatrician for guidance. They may recommend giving your baby an electrolyte solution such as Pedialyte or Infalyte.
Types of Water Babies Can Have
Once your little one is over 6 months of age, they can drink the same water you’re drinking. Giving your baby tap water is fine, and there’s no need to boil it beforehand as you would when preparing formula.
There are several infant waters currently on the market with various amounts of added fluoride. Special fluoridated water is not necessary prior to 6 months of age. If you live in an area with non-fluoridated tap water, your pediatrician will most likely prescribe an age-appropriate fluoride vitamin supplement. Ingesting too much fluoride can result in staining of the teeth (11).
Editor's Note:Dr. Leah Alexander, MD, FAAP
If you’ve been using distilled water for your baby’s formula, you may feel tempted to give it to them on its own. However, it isn’t the best choice for daily hydration.
Due to the distillation process, all minerals and nutrients are stripped from the water. While your baby can drink it once in a while, they still need some of the beneficial properties of normal water. You can balance the two, or consult your child’s pediatrician for guidance.
Water Is Life
Water is crucial, but during the first six months of life, it is best avoided for drinking. During this time, all your infant needs is either formula or breast milk.
You can begin offering water after six months as your little one starts eating solids. Give them a few sips throughout the day.
Never give a baby too much water as this could lead to water intoxication. As long as your little one is taking formula or breast milk, water isn’t as important.